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The correlation of HIV-specific Antibody-Dependent Cellular Cytotoxicity (ADCC) responses with protection from, and delayed progression of HIV-1 infection provides a rationale to leverage ADCC-mediating antibodies for treatment purposes. We evaluated ADCC mediated by different combinations of two to six neutralizing and non-neutralizing anti-HIV-1-Envelope (Env) monoclonal antibodies (mAbs), using concentrations ≤ 1 µg/mL, to identify combinations effective at targeting latent reservoir HIV-1 viruses (LRVs) from ten individuals. We found that within 2 hours, combinations of three mAbs mediated >30% killing of HIV-infected primary CD4+ T cells in presence of autologous NK cells, with the combination of A32 (C1C2), DH511.2K3 (MPER), and PGT121 (V3) mAbs being the most effective. Increasing the incubation of target and effector cells in presence of mAb combinations from 2 to 24 hours resulted in increased specific killing of infected cells, even with neutralization-resistant viruses. The same combination eliminated reactivated HIV-1 latently-infected cells in an ex vivo qualitative viral outgrowth (QVOA) assay. Therefore, administration of a combination of three mAbs should be considered when planning in vivo studies seeking to eliminate persistently HIV-1 infected cells.

Improved killing of HIV-infected cells using three neutralizing and non-neutralizing antibodies